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MorningMed is the best way to keep up with the world of health and medicine through curated round-ups, useful insights and other practical resources.

A new surveillance method for tracking Lyme disease in the United States has led to a significant increase in reported cases in 2022, with over 62,000 cases reported to the CDC, nearly a 70% rise from the previous average. However, this spike is likely due to changes in surveillance methods rather than an actual increase in disease risk, according to the CDC. The revised reporting criteria, allowing high-incidence jurisdictions to report cases based solely on laboratory evidence, may capture more cases but also pose challenges for tracking historical trends.

The U.S. Food and Drug Administration (FDA) has approved Aurlumyn, manufactured by Eicos Sciences Inc, as the first medication to treat severe frostbite in adults, aiming to reduce the risk of finger or toe amputation. Frostbite, caused by skin and tissue damage due to cold temperatures, can lead to severe complications, including amputation, if untreated. Aurlumyn's active ingredient, iloprost, a vasodilator, facilitates blood flow and prevents clotting, demonstrating efficacy in preventing amputation in patients with severe frostbite during clinical trials. Common side effects of Aurlumyn include flushing, headache, nausea, vomiting, dizziness, heart palpitations, increased heart rate, and low blood pressure.

The FDA has expanded the use of Xolair, originally an asthma medication, to help individuals with food allergies avoid severe reactions caused by accidental exposure to allergenic foods. Xolair, administered via injections every two to four weeks, allows patients to tolerate higher amounts of allergenic foods without triggering major reactions, potentially transforming their quality of life.

A study published in Nature Medicine supports the FDA's assessment that medication abortion, conducted via telehealth appointments, is safe and effective, regardless of whether patients interact with providers via video or secure chat. The research, examining over 6,000 patients, found that 97.7% of medication abortions were effective and 99.7% were not followed by serious adverse events, reinforcing over 100 previous studies on mifepristone's safety and efficacy. As the Supreme Court prepares to hear a case about mifepristone's safety and FDA regulation, the study's findings could impact the ongoing legal debate surrounding medication abortion access.

A recent report from the US Centers for Disease Control and Prevention reveals a notable shift in drug overdose deaths, with smoking drugs surpassing injecting drugs as the primary route of drug use linked to fatal overdoses. Between 2020 and 2022, the percentage of overdose deaths associated with smoking drugs surged by almost 74%, reaching 23.1%, while deaths involving injections declined from 22.7% to 16.1%. The rise in smoking drugs, attributed to factors like perceived lower overdose risk and fewer adverse health effects compared to injecting, underscores the alarming impact of fentanyl, the primary driver behind the record-high drug overdose deaths seen in recent years.

The FDA has approved a groundbreaking cancer therapy called Amtagvi, developed by Iovance Biotherapeutics, for metastatic melanoma patients who have exhausted other treatment options.

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Menopause marks a significant transition in a woman’s life, accompanied by a variety of symptoms that can disrupt daily activities and impact overall well-being. Hot flashes, anxiety, and mood swings are among the most common complaints reported by menopausal women worldwide. While there are various treatments available, ranging from hormone therapy to lifestyle changes, a recent study published on February 14, 2024, suggests a rather unconventional approach to managing these symptoms: cold water swimming.

The landscape of healthcare in the United States appears poised for disruption, given the potential of digital technology to address its shortcomings.

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Is There a Doctor in the House?

A 24-year-old woman, gravida 1, para 1, comes to the office because she and her husband have been trying to conceive for the past year without success. She gave birth to her first child at age 18 years by cesarean delivery following fetal distress. She then developed postpartum endometritis that resolved with intravenous antibiotic therapy. She used an intrauterine device (IUD) for 1 year following her first pregnancy but had the device removed because of intermenstrual bleeding. Medical history is also remarkable for chlamydial cervicitis treated with antibiotic therapy as an outpatient at age 21 years, and recurrent bacterial vaginosis that had been treated with metronidazole therapy during her pregnancy and on two other occasions. Vital signs today are within normal limits. Breast and pelvic examinations disclose no abnormalities. Hysterosalpingography shows bilateral hydrosalpinx.

Which of the following factors in this patient's history most increased her risk for development of her condition?

A new study from Uppsala University reveals that individuals who have been infected with the herpes simplex virus at any point in their lives are twice as likely to develop dementia compared to those who have never been infected. The study, conducted over 15 years with 1,000 70-year-olds, provides further evidence supporting the hypothesis that the herpes simplex virus could be a risk factor for dementia. The findings suggest the need for more research into the potential benefits of existing anti-herpes virus drugs and the development of new vaccines to reduce the risk of dementia.

Researchers from Brigham and Women's Hospital introduce a new epigenetic clock that predicts biological age from DNA structure, distinguishing between factors that accelerate and counteract aging. Published in Nature Aging, the model, termed CausAge, identifies DNA sites causative to aging-related traits and assesses interventions' efficacy. Validated on diverse cohorts, the clock correlates age-related damage with adverse outcomes and protective changes with longevity, offering insights into aging mechanisms and potential interventions' effectiveness.

Researchers at ETH Zurich, led by Professor Hubert Pausch, investigated the genes and their variants associated with fertility in bulls to gain insights into male fertility in humans. Using samples of testicles, epididymis, and vas deferens from 118 bulls, the scientists characterized the transcriptomes of different tissues to identify active genes. The findings, which revealed genes closely linked to poor fertility in bulls, could lead to improved diagnostics for infertility and help livestock breeders avoid financial losses from failed artificial inseminations.

A new study published in Nature reveals that smoking tobacco alters the immune system, making individuals more susceptible to diseases and infections even after quitting. Researchers analyzed blood samples from 1,000 healthy individuals over a wide age range and found that smoking had a significant impact on immune response, comparable to factors like age and sex. While quitting smoking improved immune response, full recovery took years, indicating the long-lasting effects of smoking on immunity, particularly affecting the adaptive immune system's B cells and regulatory T cells.

Thank you for reading! More next week,

My best wishes for a productive and idea-filled week ahead. Thanks for your ongoing efforts to improve the lives of the patients we all serve. Please send any news, comments, suggestions and ideas to hello@morningmed.email.

Quiz answer: The correct answer is C) "Chlamydial cervicitis"

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